胆管乳头状瘤病

BILIARY PAPILLOMATOSIS

目的了解胆管乳头状瘤病的特点，探讨其诊断和治疗方法。方法总结经手术和病理证实的２例资料，并结合国内外文献的复习。结果本病的特征：①病因尚不清楚，胆石和炎症的长期刺激可能与其有关。②组织学上虽呈良性，但有低度恶性倾向。具有多发性、广泛性、恶变率和复发率高的特点。③主要临床表现为黄疸和胆管炎。④术前诊断率低，影像学检查有一定帮助，胆道镜检查有很大价值。结论治疗困难。根治性手术切除是主要治疗方法。肿瘤刮除和胆管引流术后极易复发。化学治疗和激光治疗可能有一定效果。本病是肝移植的一个新指征。

Objective To understand the characteristics and investigate the diagnosis,treatment of biliary papillomatosis. Methods Two cases with confirmmed diagnosis by operation and pathology were studied,and the literature was reviewed. Results The causes of the tumor is unclear,but the long-term irritations of stone and inflammation may be related to them.Despite histological benign,it has low-grade malignant potential,charcaterized by multiple and diffusive,and has high rates of recurrence and malignant transformation.Jaundice and cholangitis are the dominant manifestations.Imaging modalities are benificial in diagnosis,and the scanning of choledochoscopy is great valuable. Conclusions The management is difficult.Curative resection is the primary therapy.Curettage and drainge may lead to high recurrence.The chemotherapy and lasertherapy may be benifical.Biliary papillomatosis may become a new indication for liver transplantation.